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Connective Tissue Manipulation is performed by the Physiotherapist using the soft pads of the fingers to move one layer of skin on the layer below. This movement creates a short, sharp, stretch reflex, creating an impulse, which spreads out through the connective tissue. The patient’s brain translates this impulse as if it were a ‘cut’ or a ‘scratch’. The tighter the connective tissue the bigger the stretch reflex and therefore the sharper the ‘cut’ feels to the patient. The reflex is a small impulse which passes through the fluid in the connective tissue and releases tension. The reduction in tension around the blood vessel walls allows more blood to flow into the damaged area and so reduces the inflammation. Softening the connective tissue also allows more movement to occur without causing irritation and therefore pain. Treatment often starts at a distance from the injured part gradually working closer to the source of injury.

The benefits of Connective Tissue Manipulation are cumulative. Once the tension has been lowered by treatment the reduction is maintained. Further reduction in connective tissue tension occurs with each additional treatment. The degree to which the reduction in connective tissue tension is maintained is conditional upon the level of stress added to the system by the patient’s lifestyle. Connective Tissue Manipulation is a technique learnt at postgraduate level in the UK and because of this it hasn’t spread very rapidly around the country. At the last count, there were something like two dozen Physiotherapists in the UK actively practising Connective Tissue Manipulation. See History of CTM